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STRATEGIES FOR THE CONSOLIDATION OF THE COORDINATION OF CARE BY PRIMARY CARE

Abstract

This study examined the coordination of care based on data from the National Program for the Improvement of Quality and Access to Primary Care. It was a descriptive study based on questionnaires answered by 1,313 users and 324 primary care teams in the city of Rio de Janeiro (Brazil), in 2012. Dimensions such as the organization of the gateway, resolution and continuity of care, horizontal integration, organization of flows and access to the referral network, informational continuity, and communication among professionals were analyzed. The results indicated that primary health care has established itself as the preferred gateway. Users reported that primary care teams sought to solve their health issues, the electronic medical record was available, although it had not been integrated into the other levels, and the professionals stated they held weekly meetings and got matrix support. However, there was a long waiting time for specialized care and a lack of communication among professionals, a fact that not only hindered the users in their pursuit for care, but also revealed networking weaknesses. There was progress in the process of strengthening primary care and challenges to the establishment of the Health Care Network that minimized the possibilities for care coordination by the primary care teams.

Keywords
health service evaluation; primary health care; family health strategy; coordination of care

Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio Avenida Brasil, 4.365, 21040-360 Rio de Janeiro, RJ Brasil, Tel.: (55 21) 3865-9850/9853, Fax: (55 21) 2560-8279 - Rio de Janeiro - RJ - Brazil
E-mail: revtes@fiocruz.br